Monday, February 25, 2019
Effect of Patient Preferred Music on Pain in Postoperative Patients
The relief of acute perturb in adult operative patient ofs continues to be a common problem scorn the use of pharmacologic therapies. Unrelieved injure domiciliate cause several(a) personal effects including change magnitude heart rate and blood pressure increased want for oxygen tachypnea increased susceptibility to infection and fear/ veneration (Swift, 2018). Nurses strive to provide the best sustainment for their patients and this includes finding alternative ways to help with unrelieved annoyance.Providing medical specialty as an adjunct to the regular of direction for pain has been shown to reduce acute pain in postoperative patients (Comeaux & Steele-Moses, 2013 Nilsson, Rawal, & Unosson, 2003 Zografakis-Sfakiankakis et al., 2017). The sideline explore proposal intended for the institutional analyse board (IRB) provide discuss the purpose of the theme background and significance goicipants and methodology recruitment participant confidentiality particip ant safety consent process risks and burdens benefits constitute and pay data and document security and follow-up and dissemination of results.Purpose of StudyThe purpose of this domain is to determine whether on the wholeowing patients to listen to their handle choice of music compared to providing them with pre-selected instrumental music is more effective, when used as an adjunct to the standard of care for pain, on trim down the perception of pain in the adult postoperative patient.Background and SignificanceThe review of literature was conducted by utilizing the following databases Cumulative Index to Nursing and affiliate Health Literature (CINAHL), Google, Nursing Times, and Research Gate. Search terms include music therapy, music, acute pain and postoperative pain. The review of literature be that music, when used as an adjunct to pharmacologic therapy, is effective in cut back postoperative pain. Pain is an expected outcome of a functional procedure, til now un relieved postoperative pain can lead to complications, delayed heal and, if not dealt with effectively, can become chronic (Swift, 2018, p. 25). jibe to Nilsson, Rawal, and Unosson, (2003) the best hold for postoperative pain control management should include both pharmacological and non-pharmacological methods (p. 700). Comeaux and Steele-Moses (2013) reported According to the Joanna Briggs Institute (2009), music therapy as a non-pharmacological ancillary to opioid analgesia is best practice in the management of pain and anxiety (p. 313).In their own watch, Comeaux and Steele-Moses (2013) found that the use of music therapy alter patient merriment of pain management in the postoperative tip (p. 314). Another psychoanalyze to a fault found that utilize music as an intervention nib in the acute postoperative period could be useful in promoting patients comfort and improving perception of pain (Zografakis-Sfakiankakis et al., 2017). Nilsson et al. (2003) reported that Music is a non-pharmacological technique, that is inexpensive, non-invasive and has no side-effects that keep been shown to reduce postoperative pain (p. 700).Music therapy has been skilful in treating patients with a wide range of diagnoses and is effective in step-down patients perception of anxiety and pain as well as the need for analgesia (American Music Therapy Association, 2010). While it has been proven that music can reduce postoperative pain, the preceding studies used pre-selected instrumental or classical music, there is special(a) research avail open in the clinical setting on the effects music has on pain with regards to providing patients with preferred music choices compared to providing them with pre-selected music.inlay and indigotin (2015) conducted a cold pressor test theater to induce observational pain to determine the impact of music theatrical role on pain and stated that Simply listen to music whitethorn not be sufficiently effective for managing pain if the music is not enjoyable for the attenderthe more likable the music is to the individual, the better the effects of music audition on the pain (p. 56). on that pointfore, it is important for takes to know which type of music to implement, preferred or pre-selected, as an adjunct to reduce unrelieved postoperative pain.Participants and MethodologyThis take away leave alone be conducted as an experimental prospective randomized clinical trial in a Level II Trauma meaning that has a complete team of general, specialty and trauma surgeons who perform a broad range of multiple surgeries daily. The anticipated number of participants is between one hundred fifty and 200 in a 2 month period. The inclusion criteria includes all patients age 18 or over who get out be having an nonappointive surgical procedure done, have an anticipated stay of 3 days or more, are alert and oriented and able to read and redeem English (for questionnaire purposes).Exclusion criteria includes any p atient with hearing loss or hearing deficit making it difficult to hear the music. Data leave alone be hive away by placing participants into two poll conclaves, the weigh group (preferred music choice) and the control group (pre-selected music). Using Zografakis-Sfakiankakis (2017) random selection algorithm participants, if they meet the inclusion criteria, allow be selected by the following on a typical surgical day, half of the patients, the 1st and 3rd patient or every other, get out be include in the see group and accordingly the 2nd and the 4th and so on will be included in the control group.A questionnaire will be given to all participants, since both groups with be listening to some type of music, and will include questions some demographic data including gender, age, race, type of surgical procedure. The remaining questions will ask the participant to rate their pain using the numeric rating scale (0-10) before the start of and after listening to at least 30 min utes of music what type of moderating what administered for their painIf any other non-pharmacologic intervention took give (i.e. repositioning or application of ice) what was the patient doing before, during and after listening to music (i.e. lying in bed, up in chair, walking in room/hall, talking with visitor, indication etc.) and the troth and total time listened to music between each pain medication administration (with at least 30 minutes per session).The study group will be given an subdued to use MP3 player with FM radio capability and will also be able to request their preferred songs and music to be downloaded to the device by the nurse researchers. The control group will also be given an easy to use MP3 player, without FM radio capability, that is loaded with pre-selected, by nurse researchers, instrumental/classical music. all in all groups will be provided with earphones to use in revise to prevent disruption to other patients.RecruitmentUpon check-in at the hos pital for their elective surgery prospective participants, who meet the inclusion criteria, will be asked if they would like to be convoluted in a voluntary research study during their hospitalization. The researchers will introduce themselves, including their credentials, and will verbally inform the individual that the study is trying to determine the effects that music has, in addition to receiving the standard of care for pain, on reducing postoperative pain.They will be advised that MP3 players as wells as earphones will be provided to them and that they will be required to fill out questionnaires during the study. Participants will be informed on how their schooling will be kept confidential, the risks and benefits of this study and after which will be encouraged to ask questions.Participant ConfidentialityTo ensure participant confidentiality and anonymity participants will be assigned a number that will be included on their questionnaires. The number that they are assign ed will be contumacious by the rig in which they leave the post anesthesia care unit (PACU). When leaving the PACU the nurse will give the known participants a manila cusp that will contain the numbered questionnaires, MP3 player and instructions on use.The first paper that the participant will see when opening the folder will include a statement to them ensuring that the information that is collected from this study from them will not be divulged to others without permission. The instructions will inform the participants to place all questionnaires and MP3 player back in the envelope upon discharge, seal it and and and so leave it in the designated locked box at the nurses station.Participant SafetyListening to music is beneficial, not subtle and non-invasive. Participants will still receive the standard of care for pain. Therefore, in this study there is no risk for harm or harmful fantasy as both groups will be provided with a music intervention, either preferred choice or pre-selected, on with the standard of care for pain. There is no anticipated adverse events seen in implementing the intervention of music listening.Consent ProcessAs part of the recruitment process, which includes providing information about the study, its procedures and allowing for questions, participants who have met the inclusion criteria will be informed that their friendship in this study is voluntary and that if they choose to infix that they can withdraw at any time without consequences.The other components of the informed consent will include basis for selection duration of interest risks and benefits confidentiality of records names of investigators and contact person statement of voluntary participation and then signature lines which will indicate consent. Even though signatures will be obtained at the time of recruitment for informed consent, the researcher will not know the identity of the participant once the study begins as they will be assigned numbers random ly as they leave the PACU.All participants will be alert and oriented consenting adults. The participants will also be informed that once this study is finished that it is the goal to have it published in a journal for medical professionals to use as evidence for best practice.Risks and BurdensAs stated earlier, there is to harmful effects or risks in the intervention of listening to music. However, potential burdens of this study could possibly overstep when filling out the questionnaire. The participants will have to take time and exertion to fill out the questionnaire each time they use the music therapy along with taking prescribed medication. This can pose as a likely inconvenience for them as they will be in a sensed state of pain.BenefitsThere are many potential benefits to the participants who take part in this study. As stated earlier music therapy has been beneficial in treating patients with a wide range of diagnoses and is effective in reducing patients perception of anxiety and pain as well as the need for analgesia (American Music Therapy Association, 2010).According to the American Music Therapy Association (2010) in addition to the reduction of pain and anxiety participants may experience improved respiration, lower blood pressure, improved cardiac output, reduced heart rate, and relaxed muscle tension (p. 4). Furthermore, the results of this study can be beneficial in providing nurses and other healthcare providers with knowledge about the best type of music to use, along with the standard of care, in reducing unrelieved pain for their patients. This information can be shared and may be beneficial as an alternative to reducing pain in various other types of patient populations as well.Cost and PaymentThere will be no cost to the participants of this study as the MP3 players and the earphones will be provided to them by the researchers. No incentives will be given in recruitment or for participation in this study.Data and Document SecurityD ocuments for this study will be kept by the patient in the provided manila folder. Once the participant is discharged the certain manila folder will be turned in by placing it in the designated locked box at the nurses station.The folders will be picked up on a daily basis. Only the nurse researchers will have penetration to the locked box as well as the questionnaires. All questionnaire collected from the hospital will then be kept in a locked file cabinet when not being used by the researchers. The data collected including informed consent will be kept for a period of 3 years.Follow-Up and Dissemination of ResultsParticipants will be given the researchers contact information and will have the option to contact the researchers after 3 months to either get the results of the study or be given an approximate date of when the results will be available. Upon completion of this study the aim is to present the research results at various presentations, submit the research results for p eer review and then ultimately spread the knowledge and the evidence-based intervention through publication in a peer-reviewed journal.ConclusionIn conclusion, we have discussed the purpose of the study background and significance participants and methodology recruitment participant confidentiality participant safety consent process risks and burdens benefits cost and payment data and document security and follow-up and dissemination of results. Researchers involved in this study welcome the critical evaluation of the IRB in order to ensure that the study will be conducted in a strong, estimable and legal manor.